Blog from Alison Clare: Test and Learn

Blog by Alison Clare, Programme Director

Identifying the small things that make a big difference

December 2016

At A Better Start Southend we want to understand the two or three key things that make a service successful, before applying what we’ve learned to improve the wider system. So we’re using a technique called ‘test and learn’ to help us quickly find out what works – and what doesn’t.

Test and learn is a bit like software development; it involves running a project on a small scale, evaluating it, making a small change and running it again to find out which changes make the most difference to the outcome. If you fail, you do so quickly, and you’ve learnt something you can apply. The idea is that within a fairly short period you can identify what works and share the learning across a whole system.

The test and learn concept has been used by retailers and banks for decades to introduce new products. It’s now being used to improve services of all kinds, and it’s at the heart of our approach to transform services for young children and their families in Southend.

It’s incredible to see the impact that small interventions can have.

For example look at NHS Change Day, which was set up to demonstrate how staff can make a difference with a small change to the way they work. A healthcare assistant wanted to improve attendance at bladder tests. She reviewed the data, spoke to patients and discovered that when it came to the day many were too scared to attend. She trialled a small change – telephoning patients five days before their appointment to answer any questions they might have. It had a real impact, reducing the number of no-shows and increasing treatment rates.

From January we’re trialling a change of our own, which we’ll run for three months. We want to engage more families who aren’t currently being reached and who need services most, so we’re changing the way that support is delivered to help us understand what stops people from accessing services. Rather than inviting parents to engage with groups in their community, support workers will visit 16 families in their homes, building relationships with them and encouraging them to get involved in community-based services. It will be really interesting to see the difference that 1 to 1 support makes in helping parents use group and community based services.

To deliver real, lasting improvements though, we have to take the lessons of test and learn beyond specific sites or services. In Southend we want to put what we learn into training modules and build them into the work of all the services babies, young children and their families come into contact with, from healthcare to housing, education to employment. And we want to learn from the experiences of parents and professionals, ensuring parents and carers are always at the heart of the process.

No single project or member of staff is going to be able to change things in Southend, but by understanding the small things that make a difference, and sharing that understanding with everyone who works with children, we hope to change outcomes for children across Southend.